Nurses' Perspectives on Family Caregiver Medication Management Support and Deprescribing.
Nurses' Perspectives on Family Caregiver Medication Management Support and Deprescribing.
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护士对家庭护理人员药物管理支持和取消处方的看法。
DOI：
10.1097/njh.0000000000000574
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Clayton,MargaretF
中科院分区：
文献类型：
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作者：
Tjia,Jennifer;DeSanto-Madeya,Susan;Mazor,KathleenM;Han,Paul;Nguyen,Bryan;Curran,Tess;Gallagher,Julia;Clayton,MargaretF
护理限制生命的疾病患者的护士在家庭照顾者（FCGs）、患者和开处方者的界面上工作，并且具有独特的地位，可以指导晚年药物管理，包括关于减少处方的挑战性讨论。本研究的目的是描述护士对其在安宁疗护FCG药物管理中的角色的看法。本研究采用内容分析的方法，对来自家长研究的护士进行定性访谈，探讨对晚期癌症患者药物管理和处方的看法。来自新英格兰3家安宁疗护机构及其转诊医院系统的10名住家及住院安宁疗护护士，被要求描述目前的药物管理及开处方实务，并评估一项规范安宁疗护药物检讨的试验工具。对10个访谈的分析显示，安宁疗护护士接受在安宁疗护过渡期进行全面药物检讨的标准化方法，并积极回应与安宁疗护护士和处方医师讨论停药的机会。有效的讨论框架包括侧重于减少有害和非基本药物以及减轻护理人员的负担。研究结果显示，照顾符合安宁疗护资格及入组病人的护士，在讨论药物危害及其对生活品质的影响时，愿意与FCGs及开处方者讨论开处方的问题。
Nurses who care for patients with life-limiting illness operate at the interface of family caregivers (FCGs), patients, and prescribers and are uniquely positioned to guide late-life medication management, including challenging discussions about deprescribing. The study objective was to describe nurses’ perspectives about their role in hospice FCG medication management. Content analysis was used to analyze qualitative interviews with nurses from a parent study exploring views on medication management and deprescribing for advanced cancer patients. Ten home and inpatient hospice nurses, drawn from 3 hospice agencies and their referring hospital systems in New England, were asked to describe current practices of medication management and deprescribing and to evaluate a pilot tool to standardize hospice medication review. Analysis of the 10 interviews revealed that hospice nurses are receptive to a standardized approach for comprehensive medication review upon hospice transition and responded favorably to opportunities to discuss medication discontinuation with FCGs and prescribers. Effective framing for discussions included focus on reducing harmful and nonessential medications and reducing caregiver burden. Results indicate that nurses who care for hospice-eligible and enrolled patients are willing to discuss deprescribing with FCGs and prescribers when conversations are framed around medication harms and their impact on quality of life.